ASD Flashcards
what are the 5 disorders included in the ASD umbrella
aspergers retts syndrome childhood autism pervasive developmental disorder pervasive developmental disorder NOS
what are the impairments in ASD
social communication social imagination social interaction repetitive behaviour restricted interest non social skills
what is social communication like in ASD
generally good language skills
difficulty grasping underlying meaning, jokes, idioms, metaphors and sarcasm
voices often monotonous, accented
narrow interests dominate conversations, lack of reciprocity
language pedantic and idiosyncratic
difficulty sharing thoughts and feelings
what is social interaction like in ASF
difficulty picking up non verbal cues
appear self focused and lacking empathy- actually trying to figure out social situations
continually struggle to make and sustain relationships
what is social imagination like in ASD
hard to think flexibly/ abstract
hard to understand other peoples points of view, take things literally
difficulty applying knowledge and skills across different settings
difficulties projecting themselves into the future/ planning sensible goals
what repetitive behaviours can occur in ASD
stereotyped or repetitive movements/ phrases
insistence on sameness, inflexible routines, ritualised behaviours
highly restricted, fixated interests
hyper/ hypo reactivity to sensory input
which gender is ASD more common in
boys 5:1 but more girls missed as present differently
how common in ASD
1-2 %
what are the theories of gender in ASD
sex hormones important in early brain development
Sex Hormone Binding Globulin (SHBG) levels are reduced in females with Asperger’s syndrome, pointing to higher levels of free testosterone
Studies in girls with congenital adrenal hyperplasia, (prenatally exposed to high levels of testosterone) showed more traits of ASD and higher levels of Gender dysphoria
very common to get gender identity issues with ASD patients
what causes ASD
multifactorial links to: rubella in pregnant mother tuberous sclerosis fragile X syndrome encephalitis untreated PKU
perinatal stress
how heritable is ASD
very 35-90%
what chromosomal abnormalities are involved in ASD
deletion, duplication, inversion
how is the brain different in ASD
frontal lobes, amygdala and cerebellum appear pathological
larger amygdala - severe anxiety, worse social skills
how is ASD diagnosed in children
speech and language difficulties:
- dont babble/ vocal sounds
- echolalia
- non verbal bahviour difficulties
lack of awareness/ interest in other children
struggle to make friends
gravitate to older/ younger children
can either be active and aloof (hyper, cant express themselves) or passive (withdrawn)
tend to play alone
difficulties with empathy, conversations, imaginative play
routines
may flap hands/ flick fingers when excited or upset
repetitive movements
sensory processing difficulties
what sensory processing difficulties can exist in ASD
senses can be over or under stimulated
taste- restricted diet
smell- toileting problems
sound- magnified, cant cut out background noise
touch- difficulties brushing/ washing hair, only wear certain types of clothing- esp on hands or feet
sight- depth perception problems, sleep problems as light sensitive
how is ASD in adults diagnosed
same as children but better adjusted to social conventions
verbal and non verbal communication problems (presents similarly to social anxiety
socially may appear shy, find it hard to fit in, few friendships, may appear rude
clumsiness, lack of coordination
sensory issues
what must you remember in diagnosis
cultural differences affecting behavioural patterns and social interactions
what are the essential criteria for an ASD diagnosis
Symptoms must be present in the early developmental period
Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning (regardless of age)
Disturbances are not better explained by other mental health problems, intellectual disability or global developmental delay
what is commonly co morbid with ASD
emotional disorders- depression, anxiety, eating disorders
neurodevelopmental disorders- tourettes, OCD, ADHD, dyspraxia and sensory processing disorder, dyslexia, language impairment
learning disability
medical disorders- fragile X, tuberous sclerosis, epilepsy, hearing and visual impairments
what is the non pharmacological management of ASD
self and family psychoeducation
Applied behaviour analysis, speech and language therapy, social skills training
Family and school based supports (Social Care to support independence in adulthood may be required)
what is the pharmacological management of ASD
Risperidone – licensed for management of severe aggression and significant self-injury
Comorbidities will require treatment
- Antiepileptics if seizure disorder
- Stimulants or non-stimulants for ADHD symptoms
- Antipsychotics for tics disorders
- In severe autism with LD mood stabilisers generally used
- SSRIs or SNRIs commonly prescribed to decrease social anxiety, treat mood and/or OCD
- Melatonin for chronic insomnia
